Dried blood spots analysis with mass spectrometry: Potentials and pitfalls in therapeutic drug monitoring
Antunes et al.
The finding, in our words
The paper found that dried blood spot assays for therapeutic drug monitoring require specific validation, particularly to address haematocrit effects that can bias drug concentration estimates. This matters because reliable microsampling methods must account for blood composition to ensure accurate results in decentralised settings.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
In AML and CLL, 91% of VAMS venetoclax results fell within 20% of plasma after individualised haematocrit correction; in home sampling, 18 of 21 patients self-sampled independently and 76% of returned samples were analysable, which shows home microsampling is workable, though the authors ask for multicentre validation.
Levens et al., Clinical Pharmacokinetics (paywalled) · source ↗
This review found that volumetric microsampling devices, such as Mitra, HemaPEN, HemaXis DB10, and Tasso-M20, overcome haematocrit bias, whilst Telimmune plasma separation cards enable direct plasma collection without centrifugation. These technologies support patient-centric, decentralised sampling, though the authors note that clinical validation remains limited across different drugs and patient populations.
Huhn & Scherf-Clavel, Therapeutic drug monitoring (paywalled) · source ↗
The study validated an LC-MS/MS method for eight antiepileptic drugs and two metabolites in dried blood spot and VAMS formats, with satisfactory analytical performance and stability, and was the first to include the oxcarbazepine metabolite DHCB. In 80 paired patient samples, microsampling concentrations showed promising correlation with plasma, supporting decentralised therapeutic drug monitoring of antiepileptic treatment.
Cobo-Golpe et al., Journal of analytical toxicology · source ↗
In matched clinical samples from rheumatoid arthritis, VAMS and DBS showed strong agreement for methotrexate polyglutamates (slopes 0.95-1.07; bias within -4.21% to 0.36%; SRCC ≥ 0.969), with up to 100% of total MTXPG results within ±20% limits; capillary microsampling agreed closely with whole blood but differed from red blood cells, indicating matrix-specific differences that must be accounted for when interpreting against RBC-based reference values.
Kocur et al., International journal of molecular sciences · source ↗
A review of 39 studies found that dried blood spot and volumetric absorptive microsampling show promising results for therapeutic drug monitoring of oral targeted anticancer drugs. The authors state that external validation remains crucial to confirm reliability, citing haematocrit effects and sample stability as key challenges.
Meertens et al., Biomedical Chromatography · source ↗